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Morning Headlines 10/9/20

October 8, 2020 Headlines No Comments

Health Records on iPhone available today in the UK and Canada

Apple makes Health Records available to IPhone users in the UK and Canada in its first expansion outside the US.

Datavant Raises $40 Million in Series B Financing to Expand Open Health Data Ecosystem

Healthcare data de-identification vendor Datavant – whose clients include 70 academic medical centers and 100 health technology and data companies — raises $40 million in a Series B funding round, increasing its total to $83 million.

Lark Health Raises $55 Million Series C to Bring A.I.-Driven Chronic Conditions Care to More People

Health coaching app vendor Lark Health raises $55 million in a Series C funding round and $15 million in a venture debt credit facility, increasing its total to $100 million.

News 10/9/20

October 8, 2020 News No Comments

Top News

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Apple makes Health Records available to IPhone users in the UK and Canada in its first expansion outside the US.

Health Records has been integrated with Cerner, Epic, Allscripts, and InterSystems.


HIStalk Announcements and Requests

Listening: Van Halen, reminding myself how good the band was as the late EVH’s Frankenstrat howled and growled through my favorite tracks like “Ain’t Talking About Love,” “Panama,” and “You Really Got Me.” It’s easy to understand why he disliked the uber-annoying but occasionally entertaining David Lee Roth, who kept me from being a big Van Halen fan, but Eddie’s rationale was at least partly musical – he thought Roth’s vocals distracted from his guitar playing similar to someone singing over a Beethoven symphony.


Webinars

October 28 (Wednesday) noon ET: “How to Build a Data-Driven Organization.” Sponsor: Newfire Global Partners. Presenters: Chris Donovan, CEO and founder, Adaptive Product Consulting; Harvard Pan, CTO, Diameter Health; Jason Sroka, chief analytics officer, SmartSense by Digi; Jaya Plmanabhan, data scientist and senior advisor, Newfire Global Partners; Nicole Hale, head of marketing services, Newfire Global Partners. The panel of data experts will discuss the opportunities that data can unlock and the challenges involved with becoming a data-driven organization. Attendees will learn why having a data strategy is important; how to collect, manage, and share data with internal and external audiences; and how to combat internal resistance to create a data-driven culture.

Previous webinars are on our YouTube channel. Contact Lorre to present your own.


Acquisitions, Funding, Business, and Stock

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Health coaching app vendor Lark Health raises $55 million in a Series C funding round and $15 million in a venture debt credit facility, increasing its total to $100 million.

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Prescription delivery company ScriptDrop raises $15 million in a Series A funding round, increasing its total to $27 million. Founder and CEO Amanda Epp, a veteran of CoverMyMeds, started the Columbus-based company in 2017 and reports a 220% increase in revenue so far in 2020 due to the pandemic. The company charges $8 for same-day delivery of prescriptions to patients who are located within five miles of the participating pharmacy. Drivers are the employees of partner courier companies rather than its own.

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Healthcare data de-identification vendor Datavant – whose clients include 70 academic medical centers and 100 health technology and data companies — raises $40 million in a Series B funding round, increasing its total to $83 million.

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Mental health telemedicine company Cerebral raises $35 million in Series A funding, proceeds from which will fund an expansion to all 50 states and development of a mobile app.

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Avail Medsystems, which offers a surgery telemedicine system that allows OR teams to access external expertise, raises $100 million in Series B funding,

Building sensor vendor Lumenix acquires the prototype of the AI-powered handwashing monitoring system AIMS from Boston Children’s Hospital.

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Google renames its G Suite business software package as Google Workspace, also adding video chatting capability to the document editing window and improving integration among Gmail, Docs, Sheets, and Calendar to better compete with Microsoft Office 365. The system was called Google Apps for Business until mid-2016. The basic business plan costs $6 per user per month.

Greenway Health announces availability of Greenway Telehealth.


Sales

  • Intermountain Healthcare chooses Vynca for Cerner-integrated access to advance care planning documents for clinicians, patients, and caregivers.
  • Prevea Health will implement the financial planning and analysis platform of Syntellis Performance Solutions, formerly known as Kaufman Hall Software. 

People

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Audacious Inquiry hires Edwin Miller, MBA (Aledade) as chief product officer; Sunil Chandran, MBA (FranConnect) as CTO; and Marie Crump, MsC (Mymee) as chief marketing officer.

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American College of Medical Informatics names Harvard Medical School biomedical informatics professor and department chair Isaac “Zak” Kohane, MD, PhD as its Morris F. Collen Award of Excellence winner for 2020.


Announcements and Implementations

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314e launches Speki, an EHR-embedded application help product that users invoke with a context-aware hot button that triggers micro-learning videos, tip sheets, and other documents that guide the user through completing the task at hand. The company will offer integration with EHRs such as those offered by Epic, Cerner, and EClinicalWorks.

Nephrology Associates goes live on Saykara’s  mobile AI voice assistant to automate physician charting.

UK patients can access information from providers who use InterSystems TrakCare via the Apple Health app, with integration with HealthShare to follow.

Epic will integrate Lyft ride-hailing into its product, allowing hospital staff to book transportation for patients.

Medicare and Medicaid technology vendor Centauri Health Solutions releases a pricing transparency solution for Epic that allows customers to comply with CMS price list publishing requirements that take effect on January 1, 2021. It offers similar products for non-Epic users.

A Central Logic-commissioned independent survey of health system executives finds that 96% will address patient leakage as one of their priorities this year, but only 31% report having the tools they need to keep patients within their networks.


Government and Politics

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Dignity Health’s St. Joseph’s Hospital and Medical Center (AZ) will pay $160,000 to settle federal charges that it violated HIPAA’s right-of-access provision. The hospital ignored a mother’s request for copies of her son’s medical records, finally delivering them 22 months later and only after OCR got involved.


COVID-19

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Most states are seeing a rise in coronavirus infection and nine have set seven-day records, with Wisconsin being among the worst in doubling case counts in the past month. The US has seen 212,000 deaths in 7.6 million cases, with both numbers representing about 20% of the world’s total. 

Nevada orders state nursing homes to stop using quick COVID-19 antigen tests from Quidel and Becton Dickinson for routine screening due to a high number of false-positive results. Both companies claimed zero false positives in their application for FDA’s Emergency Use Authorization. Experts note that FDA’s authorization for the tests cover only those people who are in their first five days of showing symptoms – they were not evaluated for screening people who don’t have symptoms. HHS required routine testing of residents and staff in late August, including those who don’t have symptoms. National testing czar Adm. Brett Giroir responded by saying that the use of antigen tests is acceptable for nursing homes despite lack of FDA authorization given the cost, delays, and material shortages in conducting PCR tests, also noting that it isn’t unusual for false positives to outnumber true positives in areas that have low coronavirus activity.

Regeneron applies for FDA’s Emergency Use Authorization for the antibody mixture that was administered to President Trump. The company says that initial supplies will be limited to 50,000 patients, but it will produce 300,000 courses of therapy within a few months and 250,000 doses per month sometime next year. Regeneron’s agreement with the federal government calls for the first 300,000 doses to be provided at no cost. Eli Lilly is also seeking authorization for its antibody product.

Moderna won’t enforce its coronavirus vaccine patents while the pandemic is underway and will license them to others afterward, explaining that “we’re not interesting in using that IP to decrease the number of vaccines available in a pandemic.”

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NEJM’s editors say in its first-ever editorial involving a political candidate in its 208 years of existence that the Trump administration has “taken a crisis and turned it into a tragedy” in being “dangerously incompetent” in its COVID-19 response, urging Americans to vote them out of office.

JAMA Network profiles a clinic whose “plain old phone calls” made up 75% of appointments during the area’s COVID-19 lockdown, with none of them involving video apps such as FaceTime. Lack of technology, comfort with its use, lack of broadband availability, and work or family conflicts leave phone calls remaining as a vital tool for vulnerable populations, for which physicians would like to see temporary reimbursement made permanent.


Other

Epic confirms to a Northwestern University news site that 45% of its employees have returned to on-campus work. (note: the 43,000 employee number is obviously a mistake and should have been 4,300).


Sponsor Updates

  • Healthcare Growth Partners advised Ontellus in its acquisition of Intertel and MasterTrace.
  • Wolters Kluwer and Meditech join forces to deliver integrated healthcare solutions across the Middle East and Africa.
  • MDLive Institute publishes a new report showing changes in consumer attitudes toward telehealth and corresponding behaviors since the start of the pandemic.
  • Elsevier launches Transition to Practice, a virtual learning and support platform for new nurses.
  • Ingenious Med adds missing clinical documentation identification functionality to its Charge Note Reconciliation.
  • First Databank Health network partner Hearst Health and the Jefferson College of Population Health honor Nationwide Children’s Hospital’s Healthy Neighborhoods Health Families program as the winner of the 2020 Hearst Health Prize.
  • CHIME’s Digital Health Leaders Podcast features The HCI Group’s CEO Ricky Caplin.
  • Health Data Movers publishes a new white paper, “Patient Monitor Deployments: How We Make It Happen.”
  • Spirion wins an Outstanding Information Security Company award for securing the information of work-from-home and another for most valuable corporate response for providing meals to restaurant staff during the COVID-19 lockdown.
  • Ingenious Med introduces new Charge Note Reconciliation capabilities, including automatically identifying missing clinical documentation and charges.
  • Healthcare organizations using InterSystems TrakCare in the UK can now offer patients a secure way to access medical data using Apple’s Health Records app.
  • Jvion CMIO John Frownfelter contributes to “Intelligence Based Medicine” by Anthony Chang.

Blog Posts


Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
Send news or rumors.
Contact us.

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EPtalk by Dr. Jayne 10/8/20

October 8, 2020 Dr. Jayne No Comments

I’ve helped numerous organizations with EHR system selection over the years, so I’m always skeptical when vendors or others report outcomes that can only be described as too good to be true. I always feel vindicated when I get to the bottom or an article and find some tidbit that I might have otherwise missed if I skimmed.

Such was the case with a recent write-up about FastMed Urgent Care implementing Epic. Although FastMed may technically be the first independent urgent care operator to take Epic live, they partnered with HonorHealth in Arizona. It’s unclear what level of partnership is present – is it a joint venture, a resource sharing agreement, or some kind of licensing deal?

The write-up morphs from a report about FastMed into a write-up about a July KLAS report where vendors were rated on their COVID responses. It goes on to quote an anonymous Epic client who says that the efficiency gained using Epic has allowed them to go from seeing 300-400 patients daily to about 1,000. If you weren’t reading carefully, you might think this was about FastMed.

It caught my eye because for an urgent care to make that dramatic leap in volumes, it would require changes in many more systems beyond the EHR, such as staffing, facilities, supply chain, and more. When actually considering information like that, it’s also important to understand the timeframe for that kind of ramp up. It’s unclear why they even included the KLAS report in the piece, but just another example of the sloppy writing that’s out there and why prospects and customers need to remain vigilant.

From Dancing Queen: “Re: resigned employees. I sat on a 1:1 call earlier this week, waiting for someone who ultimately no-showed. There was no response to outreach on Slack or email, and no out-of-office message. Turns out he gave notice around Labor Day and his last day was almost a week ago. This was a C-suite person with an administrative assistant. Why would anyone think it’s OK to leave meetings on the calendar and not notify anyone of his departure?” Unfortunately, not caring about the time of other people seems to be the new normal. I personally experience no-shows all the time, as well as people who arrive late with no notification and no apology. One company I work with has a serious issue with people just ignoring emails. Especially in the world of virtual officing, people need to revisit the ideas of common courtesy and respectful behaviors. I understand companies not doing blast notifications when people leave, but there’s no excuse for not putting on an out-of-office message that directs people to someone who is assuming responsibility for that person’s work. In one past life, we would see a little “x” in the Outlook directory in front of people who had left, but that doesn’t help if you’re an external stakeholder, vendor, or consultant.

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Telehealth has become a key part of the care team for many patients and providers, but organizations are still struggling with patient acceptance and technology glitches. Some patients seem to be more receptive than others, for example, those who had difficulty traveling to see a distant specialist or those who have difficulty taking time away from work for appointments. Others may not have the technology needed to do a visit well or may be uncomfortable discussing certain issues at home versus in the privacy of the physician’s exam room.

Now that the initial pandemic-driven pressures for telehealth services have slowed, organizations are starting to rethink their strategies. Maybe they have outgrown the quick and dirty solutions they initially deployed, or maybe they’ve realized that the vendor they chose didn’t offer all the features they need to be successful.

Organizations that are trying to move beyond the urgent care and immediate care constructs are looking for more robust technology that includes elements like remote monitoring or enhanced triage abilities that help streamline the physician portion of the visit. One consistent request I’ve heard in talking with CMIO friends is the ability to have multi-party conversations, such as with the patient and children or caregivers who may be remote not only due to distance, but due to potential quarantine or isolation. Having everyone virtually on the same page can cut down on the post-visit interactions that providers sometimes have to conduct to make sure everyone has the same information.

Others are looking for solutions that will allow multiple providers, such as a multidisciplinary care team, to see the patient at once. These integrated teams are often used for pediatric patients with complex medical problems that require follow up from a variety of subspecialists, to avoid having families travel multiple times to tertiary care centers. This is also important for patients who need translation and interpretation services.

EHR integration is also an ask, especially for those that implemented lightweight, standalone systems. Providers don’t like having to use multiple systems and screens to access data and document while they’re seeing the patient. It will be interesting to see what the provider-based telehealth market does over the next year, as well as how things turn out for direct-to-consumer applications.

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Since no one hangs out in the actual physician lounge anymore (thanks, COVID), we’ve moved to virtual forums to try to stay connected. I’m part of multiple physician and provider groups that are trying to keep each other updated on not only COVID-related happenings, but other healthcare issues, while trying to bolster our communal morale. One of the hottest topics recently has been the future availability of a vaccine for the novel coronavirus and speculation on how complicated the process will be for its distribution. We’ve been collectively pleased that vaccine manufacturers seem to be holding the line against political pressures for a premature release and that CEOs have frankly contradicted the White House’s claim that manufacturers were pushing back against FDA guidelines.

Manufacturers have plenty of skin in the game and can’t afford to rush a vaccine to market only to have it go wrong in the field. We’ve all seen those examples of drugs released without adequate testing (Vioxx, anyone?) that have come back to haunt patients, providers, and manufacturers alike. As a front-line provider, the decision to take an available vaccine is not insignificant. FiveThirtyEight put together some thoughts from vaccine professionals on how we might know when a vaccine can be trusted. Here are the best nuggets:

  • Don’t get your vaccine advice from politicians or pharmaceutical companies.
  • Trust independent scientists and medical professionals.
  • Look at information from FDA reviews.
  • Be skeptical of anything released before year-end.
  • Trust experts who are straightforward about the limitations of potential vaccines.

No one wants to get back to normal more than the healthcare providers who are in the trenches dealing with COVID and its fallout. Everyone is tired in a thousand different ways. Our hope is that people will learn to wear masks properly and consistently, that people will be vaccinated when a safe and effective one is approved and available, and that everyone will show patience and grace while all this is going on.

What’s the best example of grace under pressure you’ve seen during the pandemic? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 10/8/20

October 7, 2020 Headlines No Comments

Audacious Inquiry Expands Leadership Team and Board of Directors

Transitions of care software vendor Audacious Inquiry secures growth equity financing from lead investor TTCP and bolsters its C-suite with three new executives.

UCSF, Fortanix, Intel, and Microsoft Azure Utilize Privacy-Preserving Analytics to Accelerate AI in Healthcare

UC San Francisco’s Center for Digital Health Innovation partners with Intel, Microsoft Azure, and confidential computing vendor Fortanix to develop technology dedicated to the development and validation of clinical algorithms.

Cerebral Raises $35 Million to Expand Online Mental Health Care to All 50 States

Membership-based mental health telemedicine and prescription delivery startup Cerebral raises $35 million in a Series A funding round, which it will use to expand its services to all 50 states by the end of the year.

Avail Medsystems Raises $100 Million in Series B Funding Led by D1 Capital to Meet Demand for Procedural Telemedicine™ Technology for the Operating Room

Avail Medsystems, which specializes in telemedicine software for the operating room, raises $100 million in a Series B round led by D1 Capital Partners.

Morning Headlines 10/7/20

October 6, 2020 Headlines No Comments

Harris moves into Australia with the acquisition of Meridian Health Informatics

Harris acquires Australia-based Meridian Health Informatics, which offers maternity and clinical solutions.

Columbus health IT startup PriorAuthNow raises $10M

Prior authorization software startup PriorAuthNow raises $10 million, bringing its total raised to $32 million since launching in 2014.

Clover Health, a Next-Generation Medicare Advantage Insurer, Announces Plans to Become Publicly-traded via Merger with Social Capital Hedosophia

Medicare insurance plan operator Clover Health will go public through a merger with Social Capital Hedosophia Holdings, giving it a valuation of $3.7 billion.

Abridge, now and in the future: Announcing new product changes and our latest round of funding.

Consumer-facing healthcare encounter software startup Abridge formally launches with a $15 million Series A funding round led by Union Square Ventures and UPMC.

Statement from Universal Health Services

Universal Health Services confirms it has completed the recovery process for servers at its corporate data center, and that all of its US-based inpatient facilities have been reconnected.

News 10/7/20

October 6, 2020 News 9 Comments

Top News

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Harris acquires Australia-based Meridian Health Informatics, which offers maternity and clinical solutions.

Harris says its strategic growth plan calls for more acquisitions in Australia.

Canada-based N. Harris Computer Corporation, which operates as Harris under Constellation Software, operates 18 acquired health IT brands that include Amazing Charts, Iatric Systems, IMDSoft, Picis, and QuadraMed.


Reader Comments

From Pointy Skull: “Re: health IT podcasts and video versions of podcasts. Can you review this one?” I could, but I’m a written word, short attention span kind of guy who values conciseness and weeding out pointless fluff and would thus vastly prefer a skimmable transcript or excerpted high points (if, indeed there were any). Podcasts and videos are fine for entertainment or where a picture is worth 1,000 words, but just watching an undisciplined and / or un-insightful presenter rambling away on a screen drives me crazy. But then again, I’m often critical of industry folk whose books, presentations, or writings seem to fall short on either effort or ability.

From Usurious Rates: “Re: Hims and other vanity prescription-writing companies. Are they telehealth?” They don’t seem like it to me. Companies that sell prescription-only products related to hormones, sex, hair, or skincare by hiring doctors as prescription-writing robots are just exploiting human weaknesses — impatience, vanity, and embarrassment — in allowing customers eschew actual medical advice in favor of getting a quick prescription for whatever they’ve decided they want. I bet 98% of people who are “evaluated” by these sites end up with a prescription that creates no harm, raising the question of why the drug is prescription-only in the first place. I’m really skeptical about Hims getting into the anxiety and depression telehealth business.


HIStalk Announcements and Requests

RIP rock legend Eddie Van Halen, who died of cancer Tuesday morning at 65.


Webinars

October 28 (Wednesday) noon ET: “How to Build a Data-Driven Organization.” Sponsor: Newfire Global Partners. Presenters: Chris Donovan, CEO and founder, Adaptive Product Consulting; Harvard Pan, CTO, Diameter Health; Jason Sroka, chief analytics officer, SmartSense by Digi; Jaya Plmanabhan, data scientist and senior advisor, Newfire Global Partners; Nicole Hale, head of marketing services, Newfire Global Partners. The panel of data experts will discuss the opportunities that data can unlock and the challenges involved with becoming a data-driven organization. Attendees will learn why having a data strategy is important; how to collect, manage, and share data with internal and external audiences; and how to combat internal resistance to create a data-driven culture.

Previous webinars are on our YouTube channel. Contact Lorre to present your own.


Acquisitions, Funding, Business, and Stock

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Rock Health’s latest analysis shows that 2020 is already the largest funding year ever for digital health, with $4 billion invested in startups during Q3, for a total thus far of $9.4 billion. On-demand healthcare services like telemedicine, prescription delivery, and at-home urgent care have seen the most attention, with 48 deals totaling $2 billion.

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Medicare insurance plan operator Clover Health will go public through a merger with Social Capital Hedosophia Holdings, giving it a valuation of $3.7 billion. The company, which also offers clinical decision support software, inked a deal with Walmart Health last week to offer its Medicare Advantage plans to patients in Georgia.


Sales

  • The Chesapeake Regional Information System for our Patients (CRISP), Maryland’s statewide HIE, selects patient engagement technology — including secure access to COVID-19 testing results — from Get Real Health.

People

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Remote patient monitoring company WithMyDoc hires Frank Astor, MD (Naples Community Hospital Healthcare System) as chief medical officer.

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Shandy Guharoy (Evolent Health) joins healthcare and social services referral software vendor Unite Us as CTO.


Announcements and Implementations

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New Jersey Urology becomes the first large, independent urology group to implement Epic.

San Luis Valley Health (CO) implements Meditech with consulting help from Engage.

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Phelps Health (MO) rolls out Epic.

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A new KLAS report on team-shared mobile devices for nurses and other care team members finds that hospitals like the IPhone because it is solid and integrates will with Epic, Meditech, and Mobile Heartbeat; the ruggedized Zebra TC51-HC is heavy and expensive but allows hot-swapping batteries and can be used for barcode scanning and taking photos; and the Vocera Smartbadge has very strong software and security that is used primarily for push-to-talk conversations and texting. Spectralink and Ascom have not been able to regain the market share they lost from their early devices that were heavy and featured small screens.


Government and Politics

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Defense Health Agency Director Lieutenant General Ron Place congratulates sites in California and Nevada on their MHS Genesis go-lives, part of the DoD’s Wave Nellis launch in late September. The next wave of go-lives – the department’s third – will happen next month.


COVID-19

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The White House rejects the FDA’s higher standards for the safety and effectiveness of a COVID-19 vaccine after it says drug companies complained and the new standards would delay release until after Election Day. FDA says it has not heard those concerns from drug companies and all but one of the companies in the vaccine race have expressed their support for FDA’s guidance in the interest of bolstering public confidence. Pfizer’s CEO went on record Tuesday morning as saying the company has not discussed FDA’s guidelines with the White House. FDA says it will move ahead with the stricter standards. UPDATE: the Wall Street Journal reported Tuesday afternoon that the White House has dropped its objections and will sign off on FDA’s toughened guidelines that call for companies to monitor recipients for two months before requesting FDA’s Emergency Use Authorization.

CDC republishes its previously withdrawn warning that coronavirus can spread via airborne droplets at distances greater than six feet and linger in the air for minutes or hours, especially in poorly ventilated areas. It stresses, however, that most spread occurs from close contact with someone who is infected. The information was accidentally published to CDC’s website a few weeks ago before it had been approved and was then removed.

The White House will not perform contact tracing on attendees of the Rose Garden celebration 10 days ago that has infected at least eight people. Meanwhile, New Jersey health officials scramble to perform contact tracing of the 206 people who attended President Trump’s fundraiser at his golf club there on Thursday, for whom the Republican National Committee provided only email addresses without phone numbers or physical addresses. That event was held after White House aide Hope Hicks had tested positive, meaning everyone who had been in close contact with her for more than 15 minutes should have been self-isolating for 14 days.

Public Health England’s use of Microsoft Excel for COVID-19 test results compilation causes 16,000 cases to go unreported. PHE’s developers chose the old .XLS file format (which was replaced by .XLSX in 2007) for converting the CSV files of commercial labs, unaware that its limit of 65,536 rows would allow a single file to truncate rows after hitting around 1,400 cases.

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Salesforce announces Work.com for Vaccines, and end-to-end vaccine management system for governments and healthcare organizations that includes a public health command center, inventory management, appointment scheduling, outcome monitoring, and public health notifications.


Other

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Universal Health Services confirms it has completed the recovery process for servers at its corporate data center, and that all of its US-based inpatient facilities have been reconnected. The company was the victim of a cyberattack last week that impacted all 250 of its US facilities.

A former New York City hospital IT employee is sentenced to 30 months in prison for installing a keylogger program on the computers of 70 workers, most of them female, to steal the login credentials for password-protected personal accounts, photos, documents, and tax records. The unnamed hospital spent $350,000 to remediate the resulting network damage.


Sponsor Updates

  • The local news features CI Security’s Drex Deford’s analysis of the Universal Healthcare Systems breach.
  • Frost & Sullivan recognizes CoverMyMeds with its 2020 North American Product Leadership Award for Prior Authorization Solutions.
  • TransformativeMed will combine its clinical communication and collaboration software with clinical decision support from Crossings Healthcare Solutions.
  • Business Group on Health honors Cerner with its Helen Darling Award for Excellence in Health Care Value and Innovation.
  • Elsevier Senior Director for Scientific Services for R&D Solutions Matthew Clark wins bronze in the VHA Innovation Ecosystem and precision FDA COVID-19 Risk Factor Modeling Challenge.
  • Everbridge announces the 4th Annual Critical Event Management Impact Awards recognized the innovative use of its technology for mitigating the impact of COVID-19 and other crises in 2020.
  • Registration is now open for Experity’s Virtual User Experience half-day conference on October 15.

Blog Posts


Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
Send news or rumors.
Contact us.

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Morning Headlines 10/6/20

October 5, 2020 Headlines No Comments

It’s a brand new day for Krames

StayWell, which includes Krames patient education solutions and the StayWell employee health platform, renames itself to Krames.

Hims, a direct-to-consumer health company, is going public via SPAC

Health and wellness telemedicine company Hims will go public by merging with a special purpose acquisition company overseen by Oaktree Capital Management, bringing the company’s valuation to $1.6 billion.

Q3 2020: A new annual record for digital health (already)

Rock Health’s latest analysis shows that 2020 is already the largest funding year ever for digital health, with $4 billion invested in startups through Q3.

New Jersey Urology is the First-Ever Urology Group to Launch Epic’s Electronic Health Record

New Jersey Urology becomes the first large, independent urology group to implement Epic.

Curbside Consult with Dr. Jayne 10/5/20

October 5, 2020 Dr. Jayne No Comments

Google is doing some interesting things with COVID data overlays for Google Maps. The company states that it introduced the COVID layer in Maps “so you can make more informed decisions about where to go and what to do.” The overlay shows the seven-day average of new COVID cases per 100,000 people, with labels that show whether cases are trending up or down.

The data was accurate for my area, which is a hotbed of COVID transmission. Based on the activity of people in general, I doubt many people are consulting Google Maps to decide where they should be going since local traffic patterns indicate that everyone is everywhere.

Part of the issue stems from our lack of a statewide policy, leaving it up to individual counties to decide whether they will have restrictions or not. I live in a more restrictive county and people are flocking to the neighboring jurisdictions for dining and social activities despite the fact that numbers are going up in those areas. We hear all about the fun they’ve been having at wineries, pumpkin patches, and haunted houses when they present to the urgent care for COVID testing.

Since we have six providers out with COVID, we’re not very amused. Even though I’m not in the office for a while, I still get the text messages begging for additional provider coverage. We’re already seeing patients who are positive for both influenza A and influenza B, and vaccination season has barely started. It’s going to be a long winter, I’m guessing.

Our practice’s leadership has been quiet at providing details on how many employees have been infected with COVID and whether the exposures have been work related. I see some fairly cavalier processes with masking at times and occasionally people are gathering in break rooms despite recommendations to the contrary. I’m trying not to judge – they might be part of our population that already has had COVID and maybe they’re sharing war stories over a sandwich, but it’s still eerie when you walk up on people unmasked and closer together than the recommended six feet.

As a former administrative type, I appreciate the organization’s reasoning for being mum, but as a patient care organization, I think it’s important to address the infection control issue head-on especially since we’re still having “extended use” of our N95 masks that borders on the absurd. Fortunately, I have some angels out there who have been sourcing masks for me, so between those and the work-issued ones, I am able to swap them out frequently. I still find it hard to believe that we’re in this position at this point in the evolution of the pandemic.

Further on the topic of “things that are surprising, but not really,” I continue to see a significant number of individuals out there in the working world who don’t seem to understand the concept of “the internet is forever and it’s certainly not private.” Employers, potential employers, customers, and prospects may be looking at our activity on social media. Personal accounts can be subject to scrutiny as well as professional ones, which is why it seems surprising when people post things that raise an eyebrow or even cause a full-scale cringe.

A friend was looking at the LinkedIn profile of someone who is actively seeking a new job and found a post that didn’t exactly scream “please hire me, I’m a serious professional.” I’m not even going to quote it because I can hear my dear sweet grandmother in my head saying, “Jayney-girl, that’s vulgar.”

It got me thinking about posts that I’ve seen lately on social media that have been more than a little out of line, considering that their authors are the leaders of companies or other public-facing figures. Granted, those of us that live in the US are in the middle of what might be the most polarized presidential election in modern history, but it seems that a good chunk of the population has completely lost its sense of decorum. Whether one agrees with the idea of a social media post or not, an inflammatory tone doesn’t reflect well on one’s company or one’s leadership ability.

It has gone beyond what we used to think as “questionable” posts involving scantily-clad selfies, strip clubs, large quantities of alcohol, or venturing into tasteless subject matter. I saw one executive who re-posted political material that openly mocked the LQBTQ+ community. I’m sure their community health center and reproductive health practice clients aren’t going to be amused by it. Part of me wanted to reach out and ask if he really did post it or if he had been hacked, but seeing some of the posts that followed provided an unfortunate answer to my question.

I’ve seen what I would consider to be bad behavior much more often from my friends at startups, which may not have the same corporate social media policies as established or publicly traded companies. I’ve seen some posts that are completely absent of common human decency , but if they don’t even meet that level, they’re definitely not going to meet standards of being respectful. I  was following a company to write a piece on a company, but but have canned it because I cannot in good conscience provide visibility for an organization whose leadership is openly hateful.

In the final days that we have leading up to our presidential election, I am encouraging people to remember how we used to interact with each other, with reasoned, thoughtful conversation rather than forwarded clips and disrespectful hashtags. Once upon a time we knew how to work together towards common goals rather than bashing each other. We still have tremendous problems to solve, particularly in the healthcare arena where all of us play a role. Chronic diseases haven’t gone away, nor have preventable harms in healthcare facilities. Maternal / infant mortality in the US is still shameful, and we’re nowhere near funding public health in the way we need to fund it even after COVID exposed our shortcomings. We’re still wasting healthcare dollars because of siloed data and lack of interoperability.

We still have a rough month ahead of us, but let’s all consider taking a vow of civility. Let’s think before we speak or write and read things twice before clicking “send” or “post.” I think we’ll all be the better for it.

Email Dr. Jayne.

Readers Write: TechQuity: Influencing Health Literacy, Equity, and Disparities in Spanish-Speaking Communities

October 5, 2020 Readers Write No Comments

TechQuity: Influencing Health Literacy, Equity, and Disparities in Spanish-Speaking Communities
By Alejandro Gutierrez, MPH

Alejandro Gutierrez, MPH is team lead, customer success at Activate Care of Boston, MA.

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If Hispanics in the United States were a country, they would be the second-largest Spanish-speaking country in the world, and with $1.5 trillion in buying power, the 15th largest consumer economy in the world. According to the latest US Census data, last year marked the first year that more than half of the nation’s population under the age of 16 identified as a racial or ethnic minority. Among this group, Latino or Hispanic and Black residents together comprise nearly 40% of the population. 

The nation is diversifying faster than ever, and Latino and Hispanic communities are at the forefront. Yet we know that language barriers to accessing essential health and social services exist for all non-English speaking populations.

Recently, a study of nearly 20,000 inpatient admissions revealed patients who requested an interpreter were granted access to one only 4% of the time, and that is just for inpatient hospital care. Imagine the situation for outpatient care and social services. As a nation and healthcare system, we must do better. 

These language barriers have a negative impact on the health and well-being of the Hispanic community. Hispanic women contract cervical cancer at twice the rate of white women. Hispanics are more likely to be diagnosed with diabetes and are twice as likely to die of the disease compared to non-Hispanic whites. The stats go on. The outcomes continue. Physicians are less likely to detect depression in Hispanics, and Hispanics are 50% less likely to receive mental health treatment or counseling.

How can the healthcare system work to fix these issues? For starters, with the use of technology, healthcare providers can improve language equity. That will enable the Hispanic patient populations to become part of the majority receiving quality health and social services. 

As a member of the Hispanic community and a current member of a company working to identify SDOH (social determinants of health) in at-risk patients and provide proper care, I understand how complicated navigating healthcare systems can be for native Spanish speakers. I chose to go into public health because of my experience working and living in St. Louis, Missouri. I worked for a non-profit called Athletic Scholars Academy that ran school-based programs in under-resourced communities to promote healthy eating, physical activity, and academic achievement.

For those four years of my life, I listened to the everyday experiences of students, parents, teachers, administrators, and other school community members and learned more than I ever could in a classroom. I was regularly reminded that so many communities around the US do not have access to resources or opportunities for people to be mentally, physically, socially, and economically healthy. I learned that these differences in health are avoidable and are rooted in injustices that disproportionately affect Black and Latino communities. Working to address these avoidable differences in health became my “why” in public health.

My father is Colombian, but grew up in Spain. My mother is Indian, but grew up in Kenya. I am half Indian and half Colombian. My parents were first-generation immigrants when they came to the United States as college students and have been here ever since.

I am a first-generation American, but hearing from my parents and grandparents about the inequities in Kenya, Colombia, and India, I could draw parallels to the inequities – avoidable differences in distribution of resources and opportunities – that disproportionately affect Blacks and Latinos in America. This further reinforces why I wanted to get involved in public health. I continue to use the privilege I have been given from my grandparents and parents to do more to address health inequities in the US.

One of the first things I am lucky to have is my ability to understand and speak Spanish fluently. With that ability, I can help one of the biggest barriers Latinos face. Speaking to Spanish speakers in their native language is the first step in showing Latinos that we in the healthcare industry understand and care about them.  

As a millennial, I see the power that technology can provide in the public health space. We know that many issues of health equity are often embedded in the disconnections between healthcare and social services. Technology can offer a new chance to connect these services across the continuum of care, and can provide a more efficient and secure way of sharing and communicating information across teams that are often disconnected.

Communities across the country are taking ownership of their own abilities to exchange data across sectors. This includes healthcare, but expanding the network to include social services, behavioral / mental health services, schools, jails and courts, government agencies, managed care organizations, and more. These vanguard communities recognize that it is not enough to simply refer individuals back and forth amongst their various organizations; they have to share in the work of the interventions. Screen-and-refer approaches simply move problems from one place to the next. Screen-and-intervene approaches – built around community information exchange, care coordination, and data-driven quality improvement – are key to reducing health disparities, improving health literacy in vulnerable populations, and achieving the health outcomes we all want to see.

Morning Headlines 10/5/20

October 4, 2020 Headlines 2 Comments

CorroHealth emerges as a leader in healthcare reimbursement solutions, following merger of four industry players

Four health IT companies are acquired by private equity firm The Carlyle Group and will operate under the single brand of CorroHealth – TrustHCS (coding services), Visionary RCM (coding services), T-System (emergency documentation technology), and RevCycle+ (coding solutions).

VA on the fence about homegrown patient portal

The VA tells a House subcommittee that it is considering retiring the My HealtheVet portal in favor of Cerner’s MyVAHealth, but that move would cost $60 to $300 million since it isn’t included in its Cerner contract.

HHS Renews $10.2 Million Contract For Controversial COVID-19 Data Tracking Company

HHS issues a second $10 million contract to TeleTracking Technologies for its HHS Protect COVID-19 hospital data collection system, even as Congressional committees are investigating the circumstances under which the company was awarded the no-bid first contract.

Clinical Trials Hit by Ransomware Attack on Health Tech Firm

Clinical trials software vendor EResearch Technology is hit by a ransomware attack, forcing contract research organizations – some of which are managing COVID-19 vaccine trials – to revert to paper.

Monday Morning Update 10/5/20

October 4, 2020 News No Comments

Top News

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Meditech will end its status as an SEC public reporting company by running a reverse stock split that will allow it to de-register its shares.

Shareholders with fewer than 5,000 shares will be paid out at $45 per share to reduce the shareholder count to under 300, which will allow the company to take itself private.

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Meditech says that its public reporting status benefits its competitors, incurs costs, and provides little benefit since its shares are not traded on any public market.

More than 1,500 current and former shareholders will receive a cash buy-back that ends their company ownership and will trigger capital gains taxes.

Neil Pappalardo controls 45% of the company‘s shares, both his own $450 million worth as well as another $308 million worth that he votes as the sole trustee of the company’s profit sharing trust.

Shareholders will vote on the proposal, but board members have unanimously approved it and own enough shares to ensure its passage.  


Reader Comments

From Sea Legs: “Re: Allscripts. Another big round of layoffs, restructuring and realigning regions yet again, and rumors that some products will be sold off.“ Unverified, but reported by several people claiming to be employees on TheLayoff.com. 


HIStalk Announcements and Requests

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Poll respondents who have experienced pandemic-driven job changes most often report seeing decreased compensation or benefits, but quite a few have changed jobs and a good number saw their compensation and/or benefits improved or were promoted. I didn’t offer a “no change” option because I was interested in the changes rather than the percentage who have or have not experienced them.

New poll to your right or here: what is your most valued use of LinkedIn? I only use it to verify the job title, job history, and educational credentials of someone I’m writing about or to grab their headshot, but lately Microsoft seems to be attempting to turn it into a businessperson’s Facebook, a place where overly aggressive salespeople are unleashed to pester strangers with boilerplate pitches, and a publishing site for articles of sometimes questionable quality.

Thanks to the following companies that recently supported HIStalk. Click a logo for more information.

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Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.


Acquisitions, Funding, Business, and Stock

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StayWell, which includes Krames patient education solutions and the StayWell employee health platform, renames itself to Krames. The company was acquired by Internet Brands, which owns WebMD and Medscape, from drug maker Merck in March 2020.

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Four health IT companies are acquired by private equity firm The Carlyle Group and will operate under the single brand of CorroHealth – TrustHCS (coding services), Visionary RCM (coding services), T-System (emergency documentation technology), and RevCycle+ (coding solutions). The SEO will be Patrick Leonard, MBA, who spent several years at McKesson before moving into health IT investment.

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Virgin Pulse announces Winter ‘20, a program for health plan members and employees of client companies that will provide connections to Apple Health and Google Fit, health incentives, AI-powered member interaction and recommendations, next-best-action wellbeing tools, and a partner ecosystem. It will also help users manage their health benefits, offers evidence-based programs for weight management and pre-diabetes, and provides health content.

Shares in the Global X Telemedicine & Digital Health exchange-traded fund (EDOC) rose 3.3% in the past month versus the Nasdaq’s loss of 1.1% and the S&P 500’s loss of 2.1%.


Government and Politics

The VA tells a House subcommittee that it is considering retiring the My HealtheVet portal in favor of Cerner’s MyVAHealth, but that move would cost $60 to $300 million since it isn’t included in its Cerner contract. The VA will initially run the two portals in parallel, with Spokane-area veterans getting the Cerner portal by default after the Cerner go-live there this month, while all others will continue to access MyHealtheVet. 

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Former venture capital executive David Wagner, who received loans and grants from Connecticut’s economic development agency while he was facing fraud allegations in other states, pleads guilty to securities fraud and wire fraud charges in a plea deal. The state’s money was given to CliniFlow, a company that Wagner controlled that he said would move three medical technology startups to a building owned by Hartford Hospital in a $45 million project that would create 195 jobs. Prosecutors say it was a Ponzi-like scheme in which money from new investors was used to pay off previous investors or to pay Wagner’s personal expenses. The startups were SpearFysh, Vox MediData, and 3si Systems.


COVID-19

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HHS issues a second $10 million contract to TeleTracking Technologies for its HHS Protect COVID-19 hospital data collection system, even as Congressional committees are investigating the circumstances under which the company was awarded the no-bid first contract. The next $10 million contract extension is due in March.

Regeneron presents the first results from early studies of its monoclonal antibody cocktail three days before the product was administered to President Trump. The placebo-controlled trial of 275 asymptomatic to moderately ill people found that the drug has little effect on those who have measurable coronavirus antibodies, but it reduces viral loads and symptoms in those who don’t. Eli Lilly reported similar results two weeks ago from testing of its single-monoclonal antibody, also reporting since its study is further along that it reduced hospitalizations and ED visits. Regeneron says patients should be screened for virus levels and antibodies to decide whether to use its product, while Lilly thinks theirs should be offered to all patients who are high risk because they are elderly, have diabetes, or are overweight. 

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Public health experts question the White House’s sole reliance on Abbott’s quick COVID-19 test as protection, in which event attendees who tested negative are told that masks and distancing are unnecessary. Abbott’s ID Now test has not been approved as a surveillance tool because of limited sensitivity that can give false negative results, with FDA’s emergency use authorization covering only people with symptoms. Quarantining was not done by the President and staffers, who traveled to public events after the known positive test result of Hope Hicks, while Attorney General Bill Barr, Vice-President Pence, and other White House and campaign officials say they won’t quarantine even now despite CDC recommendations. CDC guidelines call for a 14-day isolation period for anyone who has come in contact with someone who is known to be positive, regardless of the results of their own test or lack of symptoms. Minnesota’s three Republican congressmen flew home on a Delta flight Friday night in violation of Delta’s post-exposure policies.


Other

India’s recently announced National Digital Health Mission will provide each citizen with a national health ID card that is tied to an account that will eventually include their complete medical record from all providers and serve as a research database, but experts wonder how many hospitals (especially private ones) will participate in the voluntary information-sharing program. They suggest that the country follow the models of Thailand and India, whose digital platform integrates with private health services but is deployed at the district rather than national level to keep participant counts per system at a reasonable several million.

Clinical trials software vendor EResearch Technology is hit by a ransomware attack, forcing contract research organizations – some of which are managing COVID-19 vaccine trials – to revert to paper. The company says that three-fourths of the drug trials that led to FDA approvals last year were managed using its software.


Sponsor Updates

  • Relatient’s patient engagement technology seamlessly supports hybrid care with telehealth integrations.
  • WebPT becomes Physical Rehabilitation Network’s platform partner for its Therapy Alliance for rehab therapy clinics in California.
  • SOC Telemed names Eunice Kim (Symantec) general counsel.
  • OmniSys integrates digital Medicare enrollment capabilities into its suite of software solutions.
  • Business Insider’s “AI in Healthcare Administration” report includes Wolters Kluwer among healthcare AI leaders targeting physician burnout.
  • OpenText publishes a new report, “COVID-19 Clicks: How Phishing Capitalized on a Global Crisis.”
  • In partnership with InterSystems, Ready Computing continues to deliver successful interoperable and scalable solutions for healthcare organizations.
  • Redox re-enters the Salesforce/Mulesoft ecosystem.
  • FritoLay recognizes the community service of Surescripts executive Ron Tyson through his High Fives organization as part of its Everyday Smiler program benefiting Operation Smile.
  • Premier announces that 75% of its Population Health Management Collaborative ACOs participating in the Medicare Shared Savings Program earned savings for the government, with 44% of those qualifying for shared savings payments.

Blog Posts


Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
Send news or rumors.
Contact us.

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Weekender 10/2/20

October 2, 2020 Weekender No Comments

 

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Weekly News Recap

  • A GAO report says that state prescription drug monitoring program databases would be more useful in patient care if they were more widely integrated with EHRs.
  • Nordic acquires Tasman Global.
  • The VA sets October 24 for its first Cerner go-live.
  • Epic and M Health Fairview offer Epic sites free use of an algorithm that can diagnose COVID-19 from chest X-rays.
  • A study finds that a high percentage of Apple Watch notifications of atrial fibrillation don’t result in a corresponding diagnosis and were likely not useful, also noting that nearly one-third of the patients who sought medical care as a result should not have been using the tool because they fall outside of FDA guidelines because of age or known AFib.
  • HHS and ONC launch a program with the American Board of Family Medicine to measure the use and potential burdens of health IT by office-based physicians.
  • UnitedHealthcare and Anthem end their no-cost coverage of telehealth visits that are not related to COVID-19.
  • A malware attack at Universal Health Services takes down computer and phone systems at 250 facilities, with some hospitals closing departments and diverting patients.
  • Allegheny Health Network (PA) and a Pittsburgh investor create an innovation hub that will provide seed funding to companies that are involved in diagnostics, therapeutics, medical devices, and health IT.

Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. M in Texas, who asked for hands-on STEM kits for her middle school class. She reports, “They were excited to work with all the different kits. I began each lesson with an objective, explanation, and expectations. The kits were an extension to the lessons taught. My students couldn’t finish their work fast enough to get to the hands-on part of the lesson. It is really exciting to see students eager to learn. They were engaged the whole time. It was very interesting to see how students would come up with alternative solutions to the problems they were facing.”

A Virginia couple who found a bat under the bedsheets with them is given a $500 hospital estimate after insurance to get rabies shots. The hospital charged $36,000, leaving them with a $7,000 cost after their deductibles.

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Companies are using covert surveillance software to monitor their work-from home employees, reviewing their screenshots, login times, and keystrokes. One program takes a photo from the employee’s webcam at regular intervals for managers who miss the control they had when looking over the physical shoulders of employees. One employee was caught logging in at 9 a.m. and off at 5 p.m. doing nothing in between except writing two emails. I was pressured years ago by a peer executive to send her reports about screen time and browsing history of her licensed professionals, leading to our official IT position that we weren’t in the surveillance business and management must be pretty poor if the only measurable output is adequate time sitting in front of the computer.

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In Quebec, a hospitalized Indigenous patient records video of nurses belittling her in French, telling her that she is “stupid as hell,” that “she’s good at having sex more than anything else,” and “who do you think is paying for this?” She died shortly afterward of what the family believes was an accidental morphine overdose by staff, leaving seven children behind. The hospital has fired one nurse and the family is suing.

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Irma Dryden, a black woman who served as a nurse to the famed Tuskegee Airmen during World War II, dies at 100. The New York-born nurse was assigned to Tuskegee Airfield in Alabama as her first exposure to the Deep South, when the military was segregated and black service members weren’t allowed to eat until the white soldiers had finished. Her ashes will be interred at Arlington National Cemetery. The head of the Tuskegee Army Nurses Project observes that those in the Tuskegee Airmen were fighting Adolf Hitler over human rights, but faced segregation and discrimination in their own country and even in their own military service. 


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Morning Headlines 10/2/20

October 1, 2020 Headlines No Comments

Prescription Drug Monitoring Programs: Views on Usefulness and Challenges of Programs

A GAO report finds that lack of integration of state prescription drug monitoring program tools with EHRs is the key challenge in PDMP use for patient care, with lookups requiring 3-5 minutes without integration versus 2-15 seconds with.

Nordic Acquires Tasman Global

Nordic acquires Netherlands-based EHR consulting firm Tasman Global, which expands the company’s reach into Europe and Asia.

Third time’s the charm? VA sets new date for initial electronic health record rollout

The VA plans to go live with a first round of Cerner EHR capabilities on October 24 at the Mann-Grandstaff VA Medical Center in Spokane, WA, with a second round scheduled for next spring.

Phreesia Acquires Co-Developed Patient Care Applications by Merck and Geisinger

Patient intake platform vendor Phreesia acquires two workflow applications that were developed by Geisinger and drug company Merck.

FastMed Becomes the First Independent Urgent Care Operator to Launch Epic

FastMed Urgent Care goes live on Epic at its 29 Arizona locations, the first independent urgent care operator to do so.

News 10/2/20

October 1, 2020 News 2 Comments

Top News

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A GAO report finds that lack of integration of state prescription drug monitoring program tools with EHRs is the key challenge in PDMP use for patient care, with lookups requiring 3-5 minutes without integration versus 2-15 seconds with.

Physicians said PDMP access helps them detect doctor-shoppers and also helps them avoid prescribing duplicate drugs or ordering doses that are too high when taken with other drugs.

Most of the 31 doctors who were interviewed said their PDMP is not integrated into their EHR.

They also reported that they could not access the PDMPs of other states, that dispensing records from opioid treatment facilities and the VA aren’t always included, and that PDMP searches are hampered by patient matching problems.


HIStalk Announcements and Requests

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A reader asked me to note that Nordic VP Pat Hingley will hit the 50-year mark in her healthcare IT career Friday, going all the way back to her teen job as a full-time “data processing” employee who rigged an IBM 402 accounting machine (a punch card reader with an integrated printer) to produce clinic reports (gifters: the 50th calls for gold). Congratulations to Pat. Is anyone else out there hitting their health IT semicentennial?


Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.


Acquisitions, Funding, Business, and Stock

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Nordic acquires Netherlands-based EHR consulting firm Tasman Global, which expands the company’s reach into Europe and Asia. Tasman founder and CEO Adrienne Flatland was a Willow implementer at Epic for seven years, then started the company in 2015.

Walmart will offer Medicare Advantage plans for Georgia seniors that will give them access to its Walmart Health Centers.

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Patient intake platform vendor Phreesia acquires two workflow applications that were developed by Geisinger and drug company Merck – Family Caregiver (a SMART on FHIR-integrated patient-provider communication app) and MedTrue (medication reconciliation and adherence).

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Israel-based personal health monitoring solutions vendor G Medical Innovations files IPO plans that values the company at $329 million. The early-stage company reports annual revenue of $5 million. The company will de-list its shares from the Australian Securities Exchange, which have a market cap of $33 million, before moving to the Nasdaq. One-year performance on the ASX finds company shares down 65% to $0.04. 

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ProPublica looks at a private equity firm’s acquisition and expansion of Prospect Medical Holdings, which it expanded to 17 hospitals and loaded with $400 million in debt, with the PE firm’s CEO and one of his executive peers personally pocketing $222 million. Meanwhile, the hospitals report non-working elevators, ambulances that can’t fill their gas tanks because of unpaid gas card bills, and shortages of medical supplies and PPE because of overdue bills. One of its hospitals had the first COVID-19 death of an ED doctor, who reported being forced to wear a single mask for four days, while another had six COVID patient deaths in a 21-bed locked psychiatric ward due to poor infection control. The chain has been accused of fraudulent Medicare billing and is running out of cash with high debt and a laundry list of hospital quality issues.


People

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Medical practice marketing technology vendor PatientPop hires Arman Samani, MBA (AdvancedMD) as chief product officer. He was announced as chief product officer for animal health technology vendor Covetrus on June 1, 2020, but I guess that didn’t work out since it’s not on his LinkedIn.


Announcements and Implementations

FastMed Urgent Care goes live on Epic at its 29 Arizona locations, the first independent urgent care operator to do so. The company’s clinics in North Carolina and Texas are up next in early 2021. FastMed chose Epic in January 2020 and announced last month that it has formed a joint venture with Phoenix-based non-profit health system HonorHealth, which uses Epic, to operate all of its Arizona clinics.

Netsmart integrates its MyUnity hospice EHR with Delta Care’s pharmaceutical care solution, allowing hospice nurses to consult with Delta Care’s pharmacists for medication changes that are then integrated into the EHR.

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Amwell will integrate TytoCare’s $250 on-demand medical exam device with its telehealth platform, allowing providers use its stethoscope, thermometer, otoscope, tongue depressor, and camera in virtual visits. 

Banner Health reduces unnecessary medication-related decision support and dosing alerts by one-third, working with Cerner Continuous Improvement Delivery to by studying its own alert history and implementing best practices from other Cerner clients.

Specialty pharmacy operator AllianceRx Walgreens Prime will integrate medical data from the recently announced Inovalon DataStream. I spent several minutes reading the announcement and Inovalon’s website trying to figure out exactly what DataStream, ScriptMed Cloud, and Inovalon One do exactly (beyond spawning buzzwords) but I lost interest.

OSF Healthcare goes live on Kyruus ProviderMatch for Consumers on its website.


Government and Politics

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The Department of Justice charges 345 people, including more than 100 medical professionals, with submitting $6 billion in fraudulent medical claims, most of them related to telemedicine. Telemedicine company executives were accused of paying doctors and nurse practitioners to order medically unnecessary medical equipment, genetic counseling services, and pain medications with minimal or no interaction with the patient, then selling the orders to other companies. CMS has revoked the Medicare billing privileges of 256 more medical professionals for their involvement.

Mann-Grandstaff VA Medical Center (WA) will go live on Cerner on October 24 in the VA’s first activation.


COVID-19

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Bloomberg describes the coronavirus precautions used by the University of Arizona, which include installing tents so students can wait for classes outdoors in the shade, sending student health ambassadors around campus in golf carts to hand our masks and to offer distancing reminders, requiring returning students to take a rapid coronavirus test, and performing daily wastewater analysis to quickly identify dorms in which someone is infected. The program was designed by 17th Surgeon General of the United States Richard Carmona, MD, MPH, who is a public health professor at the university. He dropped out of high school to join the US Army Special Forces as a medic and was decorated for combat in Vietnam. He earned a GED, completed a nursing program, then attended UCSF to earn undergraduate and medical school degrees and later University of Arizona for an MPH. Carmona has practiced as a paramedic, RN, surgeon, and deputy sheriff and has held leadership roles in emergency services, hospitals, and the Pima County, AZ health system. He issued the Surgeon General’s report on the effects of second-hand smoke.

Cornell researchers find that President Trump is the single largest driver of coronavirus misinformation that has appeared in major English language news outlets around the world, which they found ran false information – often without the publication’s own commentary or correction — about miracle cures, political conspiracy theories, and Anthony Fauci, MD. Mentions of the President made up 38% of the overall “misinformation conversation.” Just under 3% of articles contained falsehoods.

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University of Minnesota researchers develop an Epic-integrated AI algorithm that can diagnose COVID-19 from chest X-rays, which Epic and M Health Fairview will make available to all Epic sites without charge. All 12 M Health Fairview hospitals are using it.

Northwell Health develops a COVID-19 early warning system that analyzes patterns in its website traffic to predict demand for staffing and supplies. It says the two-week prediction has tracked closely to actual caseload so far, adding that it will offer the source code to other health systems who have the expertise to convert it to work with their own websites.

The CEO of Pfizer says in a company memo that he is disappointed that political rhetoric around coronavirus and vaccine development is “undercutting public confidence,” adding that despite the $2 billion the company has risked in not accepting money from any government, it will not succumb to political pressure to release a vaccine either faster or more slowly than “the speed of science” allows.

Two companies that were developing at-home, antigen-based saliva tests for coronavirus have abandoned those plans, as public health experts say it was naive to think that the virus antigen would predictably collect in the mouth. Saliva seems to work for PCR testing, but those tests are subject to testing material shortages and require hours to provide a result.

The US government turns distribution of remdesivir back over to its manufacturer, Gilead Sciences. The drug, which has proven to be modestly useful in shortening COVID-19 hospital stays without reducing deaths and whose development was partly paid for by US taxpayers, costs $3,120 per course of treatment. The company will make at least $9 billion in 2020-21 since its manufacturing cost has been speculated to be less than $1 per vial.  


Other

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Kaiser Health News covers the offshore scribe industry, where young, aspiring healthcare professionals in India toil overnight their time to create EHR documentation of US office visits. Augmedix recruits college graduates who can pass tests for English reading, listening comprehension, and writing, then sends them to a three-month training program that covers medical terminology, anatomy, and physiology and then takes them through mock visits. Scribes there earn an average of $500 per month, 20% of what their US counterparts are paid, and their time is billed at $12 to $25 per hour. Companies say remote scribing is a small but growing part of the market. Doctor-owned Physicians Angels offers audio-only services (saying that video is intrusive to patients and scribes should be paying attention only to what the provider verbalizes), says it can’t be breached since scribes enter information only in the client’s EHR, completes charts the same day since anything else is just a transcription service, and offers a no-obligation trial for 30 days at $15 per hour. The company’s founder and CEO is a Toledo-based, US-educated otolaryngologist. 

Canada-based preventive health operator Medisys Health Group pays a ransom to restore the data of 60,000 of its patients. The company is owned by digital health solutions vendor Telus Health, which bought the chain from its private equity owner in August 2018 for $100 million. Parent company Telus, a telecommunications vendor, offers cybersecurity services. 

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Mayo Clinic researchers find in a small study that 85% of people who receive an atrial fibrillation warning from their Apple Watch don’t end up with a corresponding diagnosis, leading them to warn that such widespread screening is likely causing overuse of healthcare resources from the “worried well.” They also observe that 8.7% of the patients who reported Watch AF warnings were under 22 years of age and 22% had known atrial fibrillation, meaning that they should not have been using the Apple technology per FDA guidance regarding use cases that have not been studied.

Campbell County Health (WY) receives a $1 million insurance settlement toward an estimated $1.5 million in cost for a September 2019 ransomware attack that wasn’t fully resolved until December 2019.


Sponsor Updates

  • Insight Success names Goliath Technologies Chairman and CEO Thomas Charlton a top 10 influential leader in medtech.
  • Arcadia extends its free vaccination, preventative screening, and appointment reminder outreach program to additional at-risk patient populations.
  • Cerner releases a new podcast, “Why you don’t want to miss Cerner Health Conference 2020.”
  • Saykara will host a virtual roundtable on using AI to reduce physician burnout on October 28.
  • Hayes CTO Ritesh Ramesh wins Silver in the CEO World Awards, Executive Achievement of the Year for IT Services category; and the company wins Bronze for Team of the Year in the inaugural COVID-19 Business Response category.
  • Wolters Kluwer Health publishes a new report, “Closing the Nursing Education-Practice Readiness Gap.”
  • Medhost and Senator Bill Frist discuss improving rural healthcare.

Blog Posts


Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
Send news or rumors.
Contact us.

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EPtalk by Dr. Jayne 10/1/20

October 1, 2020 Dr. Jayne No Comments

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For those of you still playing along with the Medicare Promoting Interoperability Program, October 3 is the last day to begin the required 90-day EHR reporting period. This applies to eligible hospitals who want to try to avoid getting a negative payment adjustment (aka penalty) down the road.

It’s hard for some organizations to even care about the CMS programs any more. They are trying to keep their doors open on a month-to-month basis, and the idea of future penalties isn’t on the radar when they’re juggling staffing issues and figuring out how to protect their employees.

Another deadline approaching is that for submitting comments on the 2021 Proposed Rule for the Quality Payment Program. That comment period closes October 5 at 5 p.m. ET and comments may be submitted through regulations.gov.

COVID and the related lockdowns, shutdowns, and limitations to healthcare delivery are having negative impacts on patients in other ways. The Morbidity and Mortality Weekly Report from September 11 presents the results of a survey done in June looking at patients whose routine care was delayed. The survey estimates that 41% of US adults have delayed or avoided care, including 12% who reported having avoided urgent care.

A close friend of mine is going through some stress following a delay of care. When she was finally able to get in for her annual GYN exam, there were some abnormal findings, and now she’s beating herself up about whether they would have been found earlier had she gone in April as originally scheduled. I reminded her that in her age group she’s not even recommended to have an annual pap test, which means that her physician performed it “early” per the guidelines rather than “late” due to COVID. It’s hard for most laypeople to wrap their minds around how guidelines are constructed, especially when they’re worried whether they have cancer. At least her care team is running full tilt now, so hopefully she’ll have the answers she needs very soon.

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ONC announces the awardees for the STAR HIE (Strengthening Technical Advancement and Readiness of Public Health Agencies via Health Information Exchange) program. The goal was to support state and local public health agencies, as they use health information exchange services to respond to public health emergencies such as natural disasters and pandemics. Five HIEs were each awarded two-year cooperative agreements: Georgia Health Information Network, Health Current (AZ), HealthShare Exchange of Southeastern Pennsylvania, Kansas Health Information Network, and Texas Health Services Authority.

I enjoyed this article in Nature looking at how researchers are using virtual assistants to diagnose coronavirus infections along with dementia, depression, and more. Vocalis Health, a start-up with offices in Israel and the US, modified an app that was being used to detect worsening chronic obstructive pulmonary disease in an effort to detect COVID-19. They asked patients who had tested positive to use a research app to record their voices, with the recordings processed through machine learning to try to identify a COVID voiceprint. The article goes on to cover the history of voice analysis with neurodegenerative conditions such as Parkinson’s disease as well as how it can be used for behavioral health conditions like mania, where voice features can be telling. I ran the article past my favorite voice expert who thought it was “very fascinating,” although I’m personally curious about how it handles patients speaking different languages with different dialects and regional accents.

Greenway Health is getting into the telehealth game with a solution slated to be available in October. It claims to “deliver quality care from remote locations without interrupting established workflows” and they’ve got a video on the website from their chief product and technology officer, but I’d find it a lot more credible if they had a physician announcing it. The rest of the information requires you to provide your information, so I took a pass.

My state chapter of the American Academy of Family Physicians reached out to me on behalf of the state department of health as they try to plan for administration of a COVID-19 vaccine. The documentation is extensive, including a participation agreement and a multi-page provider profile that requires details down to the brand, model, and type of storage unit that will be used for housing COVID-19 vaccine prior to administration. Based on our already unstaffable volumes, I can’t see my practice agreeing to be an administration site, but you never know.

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I registered for the all-virtual Lenovo TechWorld conference today, to be held at the end of October. Based on my interests, it suggested a couple of sessions for me. I’m not sure where the “liquid cooling innovation” one might have come from, but it does sound pretty cool (pun intended). Unlike an in-person conference, it’s easy for the day-to-day to get in the way of virtual conferences, so we’ll see if I make it to any of the sessions.

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I’m mostly interested in seeing how the virtual conferences run and what platforms they use, as well as how they engage (or don’t engage) attendees. The Optum Forum had some glitches this morning, with participants having to log out and back in as well as reload their browsers to continue. Sessions that may have been missed are posted for on demand viewing through October 30, however.

I’ve been dealing with some non-work issues lately, so I’ve been much more likely to answer phone calls from unknown numbers. I had the ultimate bad cold call the other day. I answered the phone as I always do, “Hi, it’s Dr. HIStalk” and the caller says, “Jayne, this is Dave.” “Sorry, Dave who?” “You know, Dave, from XX company. We met at the YY conference a couple of months ago (insert name of conference that I most certainly didn’t attend, because you know, COVID) and you said to call you in a couple of months.”

“I’m sorry, what is this about?” “I wanted to follow up on your cybersecurity needs.” When I began to explain that I don’t have any cybersecurity needs, he literally hung up on me. Definitely not a best practice for the sales playbook, and needless to say, his number is now blocked. I’ll also be making sure that all my hospital and healthcare friends who might actually have pressing cybersecurity needs know what bozos the company has hired so that they’re not inclined to give them their business.

What’s the worst cold call you’ve received? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 10/1/20

September 30, 2020 Headlines No Comments

CORHIO and Health Current Join Forces and Announce Intent to Form New Regional Organization

Colorado-based CORHIO and Arizona-based Health Current announce plans to merge, potentially creating the largest HIE in the Western United States.

Private equity firm’s healthcare SPAC SCP & CO Healthcare Acquisition files for a $200 million IPO

Blank-check company SCP & CO Healthcare Acquisition files for an IPO of up to $200 million.

Nebraska Medicine to resume appointments, procedures after battling cyberattack

Nebraska Medicine resumes all appointments, procedures, and surgeries after making “significant progress” in recovering from a cyberattack on September 20.

HHS Announces Funding for Health Information Exchanges to Support Public Health Agencies – STAR HIE Program Funds Five Organizations to Improve Interoperability of Health Data

GaHIN, Health Current, HealthShare Exchange, KHIN, and Texas Health Services Authority will receive a combined $2.5 million from the HHS STAR HIE Program to better support public health agencies in their response to emergencies like COVID-19.

Apple Accused of Delaying Masimo Legal Fight to Gain Watch Sales

Masimo contends in a court filing that Apple is trying to delay a legal fight over allegedly stolen blood-oxygen monitoring technology in its latest Apple Watch so that it can gain more market share.

Readers Write: Technology Augmented by Behavioral Science Theory Leads to Improved Health

September 30, 2020 Readers Write No Comments

Technology Augmented by Behavioral Science Theory Leads to Improved Health
By Rhea Sheth

Rhea Sheth is a clinical and marketing intern at Carium and an undergraduate student at the University of California, Berkeley studying integrative human biology.

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Behavioral science is the study of human behavior. It asks the question: why do we act the way that we do? The simplicity of this question masks a complex science that underlies it.

Understanding human behavior has many invaluable applications in our society. If we can better understand human behavior, we can shape our policies in a way that will better engage individuals or present public health information in a way that will lead to an increased compliance rate.

The intersection of behavioral science and technology is an area of huge opportunity. With the rise of technology, there has also been a rise in the number of opportunities to move healthcare away from a fee-for-service model and instead move towards a value-based approach. The incorporation of behavioral science theory into mobile health platforms can help facilitate the movement towards more patient-centric care and improved health outcomes.

Research-backed behavior change techniques should be intentionally incorporated in digital health platforms to help individuals manage chronic disease. Influencing behavior change in chronically-ill patients is a crucial public health intervention. According to the CDC, 6 in 10 adults in the US have a chronic disease and 4 in 10 adults in the US have two or more chronic diseases.

Smartphone apps are a convenient, cost-effective way to provide behavioral interventions at the appropriate times. In addition, they help reduce healthcare disparities by increasing reach to populations who were previously unreachable due to demographic, socioeconomic, and geographic barriers.

Behavior change techniques can be woven into virtual healthcare tools to help users identify and manage negative behaviors that may be contributing to worsened health outcomes. Self-monitoring is one of the techniques that enable this type of positive behavior change and has been found to lead to reduced hospitalization and readmission rates.

In the context of healthcare, this includes tracking metrics indicative of health-related behaviors such as calories eaten, weight change, and blood pressure levels, often collected through devices such as wearables and fitness trackers. Through digital health platforms, users can track their desired metrics in which they can also see short-term and long-term trends in their health data. This data can be shared with care teams and providers can then keep track of their patients’ health metrics through remote patient monitoring (RPM).

According to the American Heart Association, through RPM, providers can obtain a more holistic view of the patient’s health through data, gain insight into a patient’s adherence to treatment, and develop a deeper patient-provider relationship. RPM can also help reduce healthcare costs by enabling timely health interventions before a patient’s health deteriorates to the point of requiring a costly procedure.

Before the rise of mobile health, self-monitoring was done primarily through paper journal methods, where participants would manually record entries such as calories eaten, blood pressure readings, and blood sugar levels. With recent advances in mobile technology, there are opportunities for more convenient, real-time self-monitoring. Rather than having to carry around a bulky paper journal, individuals can simply enter their data into a mobile device and see their short- and long-term trends.

For an individual with diabetes, taking a daily measurement of blood sugar can help increase awareness about their positive or potentially harmful behaviors. Seeing a huge spike in blood sugar one morning can cause the individual to, first of all, be aware that there is a change in their health, and then reflect on what actions could have caused that. They might remember that they ate three fudge sundaes last night and did not go on their daily walk. The question is, are they now likely to change their behavior?

Here’s where behavioral science comes in again. The act of self-monitoring has increased the probability of behavior change by making the individual aware that there is a change in their health. However, the act of self-monitoring does not guarantee that someone will change their behavior. The next day, the individual may have a craving for ice cream and engage in harmful behavior again.

While they may be aware now that eating ice cream is affecting their blood sugar in such a drastic manner, there may be other underlying factors that cause the individual to perpetuate a negative behavior. It may be that the individual does not understand the consequences of having high blood sugar because they haven’t received information regarding its risks. It may be that they are lonely and feel like no one cares about their health because they do not have frequent access to a healthcare professional. Or, it may be that the individual has a goal of reducing blood sugar but does not know how to achieve that goal and thus becomes demotivated.

To help mitigate the risk of perpetuated negative actions, mHealth apps can integrate different behavior change techniques with self-monitoring to enhance user engagement and increase the probability of behavior change, such as secure messaging and educational materials. Secure messaging is one way for providers and patients to interact and strengthen their relationship, and learning materials such as diabetes-self management education also help improve health outcomes.

Studies show that self-monitoring is more effective in improving health outcomes when used in conjunction with other behavior change techniques in this manner. Self-monitoring was also found to lead to reduced hospitalization and readmission rates.

Making sure technology caters to the complexity of a human being is imperative. Behavior change techniques help us do that. There is no one-size-fits-all solution for behavior change, but intentionally designing technology based on research-backed behavior change techniques has been shown to improve health outcomes. In this way, we make movement away from episodic transactional healthcare and instead towards mutually beneficial, patient-centered, and holistic healthcare.

Much like having a trainer at the gym can motivate people to reach their fitness goals and feel stronger, more confident, and successful, having a digital health platform with specific behavior techniques such as self-monitoring, health coaching, prompts / reminders to take medication, and motivational messages can help patients achieve their health goals.

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